■像数字盒教练和VR这样的数字工具似乎有望在外科诊所之外提供安全和量身定制的实践机会。然而,了解它们的功效和局限性至关重要。这项研究调查了哪些数字工具可用于培训手术技能,如何使用这些工具,它们有多有效,以及他们打算教授什么技能。
■Medline,Embase,和Cochrane文库进行了系统的随机试验审查,根据手术住院医师的客观结果(技能得分和完成时间)评估数字技能培训工具。将数字工具的有效性与对照进行了比较,湿/干实验室培训,和其他数字工具。工具和训练因素亚组进行了分析,并对其主要结局进行了评估:技术和/或非技术。
■纳入的33项研究涉及927名居民和6种数字工具;数字盒子培训师,(沉浸式)虚拟现实(VR)培训师,机器人手术教练,指导和反馈,严肃的游戏。数字工具在技能得分方面优于控件(SMD1.66[1.06,2.25],P<0.00001,I2=83%)和完成时间(SMD-1.05[-1.72,-0.38],P=0.0001,I2=71%)。数字工具和实验室培训之间没有显着差异,在工具之间,或其他子组。只有两项研究侧重于非技术技能。
■虽然数字工具在提高技术手术技能方面的功效是显而易见的-特别是对于VR培训师来说-缺乏关于非技术技能的证据,并且需要在课程中实施新的(数字)工具之前提高研究的方法论稳健性。
■这项研究为数字工具在外科培训中的日益普及提供了重要的见解。在确定当前挑战的同时展示它们的有用性,特别是关于方法论的稳健性和对非技术技能的忽视。
UNASSIGNED: Digital tools like digital box trainers and VR seem promising in delivering safe and tailored practice opportunities outside of the surgical clinic, yet understanding their efficacy and limitations is essential. This study investigated Which digital tools are available to train surgical skills, How these tools are used, How effective they are, and What skills they are intended to teach.
UNASSIGNED: Medline, Embase, and Cochrane libraries were systematically reviewed for randomized trials, evaluating digital skill-training tools based on objective outcomes (skills scores and completion time) in surgical residents. Digital tools effectiveness were compared against controls, wet/dry lab training, and other digital tools. Tool and training factors subgroups were analysed, and studies were assessed on their primary outcomes: technical and/or non-technical.
UNASSIGNED: The 33 included studies involved 927 residents and six digital tools; digital box trainers, (immersive) virtual reality (VR) trainers, robot surgery trainers, coaching and feedback, and serious games. Digital tools outperformed controls in skill scores (SMD 1.66 [1.06, 2.25], P < 0.00001, I2 = 83 %) and completion time (SMD -1.05 [-1.72, -0.38], P = 0.0001, I2 = 71 %). There were no significant differences between digital tools and lab training, between tools, or in other subgroups. Only two studies focussed on non-technical skills.
UNASSIGNED: While the efficacy of digital tools in enhancing technical surgical skills is evident - especially for VR-trainers -, there is a lack of evidence regarding non-technical skills, and need to improve methodological robustness of research on new (digital) tools before they are implemented in curricula.
UNASSIGNED: This study provides critical insight into the increasing presence of digital tools in surgical training, demonstrating their usefulness while identifying current challenges, especially regarding methodological robustness and inattention to non-technical skills.